People crave security. For those familiar with Maslow’s hierarchy of needs, safety and security are essential foundations of life. One way civilization has provided that safety and security is by pooling resources together for the common good. In the United States, commercial health insurance has been one such strategy to meet the common good.
We all know this strategy has been under a lot of pressure. Many of us have had to pay much more towards our health insurance while receiving much less in terms of covered services. This affects doctors as well. I’m currently buying my health insurance on the exchange.
My out of pocket health insurance costs are $2000 per month, post-tax. When people get insurance through their corporate employer, premiums are paid pre-tax. My business here at Candid is too small to qualify for group discounts when purchasing health care insurance. In addition, my exchange insurance plan is a high deductible plan. And, to add insult to injury, the insurance company did a bait and switch. When we signed up for the plan in late November 2025, our doctors were on the plan. When the plan went into effect Jan 1, 2026, none of our doctors were covered on the plan. There was only 1 pediatric practice that accepted our insurance, and there are 0 (zero) primary care doctors accepting adults with our insurance. The website is directing me to Bend (2 hour drive away) or Albany/Salem (1+ hour drive away).
Is this sounding familiar?
On the practice operations side, dealing with insurance is also tricky. In the past year or so, insurance companies have: 1). Told me they don’t have phones to talk with doctors about claims, 2). Rejected electronically filed insurance claims because “I must have mistakenly filed the claim,” and 3). Rejected payment on services for requirements “we just made up.” (exact quote).
As you all know from the news, insurance companies have been continuing to decrease or deny payments to hospitals and physicians. Medicare and Medicaid payments have not kept pace with inflation, either. Physician practices and hospitals are facing enormous financial headwinds. Meanwhile, insurance companies continue to make profit.
The good news is that here at Candid Medical, we focus on Lifestyle Medicine. Most diseases in the Western world are preventable through lifestyle practices. That means no medication, no dementia, no heart attacks, much reduced risk of cancer… That sounds like one great insurance policy!
See you soon!
-Dr. Joe
Photo by Piotr Chrobot on Unsplash
